비구면 다초점 인공수정체를 단안에 삽입한 백내장수술의 장기 임상결과
One-year Outcome of Monocular Implant of Aspheric Multifocal IOL
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목적: 비구면 다초점 인공수정체인 Tecnis ZM900을 단안에 삽입한 환자들의 장기 임상결과를 알아보고자 하였다. 대상과 방법: Tecnis ZM900을 단안에 삽입한 30안을 대상으로 술 후 1주, 1개월, 3개월, 1년에 나안 근거리 및 원거리 시력, 근거리및 원거리 최대교정시력, 굴절오차 및 대비감도를 측정하였고, 주관적인 시각증상(빛번짐, 눈부심), 안경 착용 유무 및 만족도에 대해조사하였다. 결과: 술 후 1년째 평균 나안 원거리시력은 0.11±0.08 (logMAR), 근거리 시력은 0.25±0.17 (logMAR)이었다. 대비감도검사상 술 후1년째 명순응(1.5,3 cpd)과 암순응(6,12,18 cpd) 영역에서 유의한 호전을 보였다(p＜0.05). 만족도 조사에서 30명의 환자 중 26명에서만족스러운 결과를 보였으며, 안경 착용자는 6명이었다. 술 후 결과에 불만족스러웠던 경우는 8안이었고 주원인은 야간 눈부심과 빛번짐 때문이었다. 결론: Tecnis ZM900 인공수정체는 만족스러운 원거리 및 근거리 시력 교정, 대비 감도, 술 후 환자의 만족도를 보여 안정적인 인공수정체라고 판단되지만 빛번짐 및 야간 눈부심 현상은 만족도를 떨어뜨리는 요인으로 조사되었다.
Abstract
Purpose: To evaluate near and far visual acuity, subjective visual symptoms, and patient satisfaction with a monocular implant of aspheric multifocal IOL (AMO Tecnis ZM900Ⓡ). Methods: Thirty eyes of 30 patients received phacoemulsifications and monocular implantation of Tecnis ZM900 IOL. The main outcome measures at postoperative 1 week, 1 month, 3 months, and 1 year were uncorrected and corrected near and distant visual acuity, refractory errors, contrast sensitivity, subjective visual symptoms (glare and halo), spectacle independency, and satisfaction. Results: At a 3 month postoperative visit, the mean uncorrected near and distant visual acuities were 0.29±0.17 (logMAR) and 0.16±0.12 (logMAR),respectively. At 1 year, the mean uncorrected near and distant visual acuities were 0.25±0.17 (logMAR) and 0.11±0.08 (logMAR). Glare and halo decreased, and contrast sensitivity increased upon 1-year follow-up after monocular implantation of ZM900. Most patients (87%) were satisfied with their visual outcome. Conclusions: Monocular implantation of multifocal IOL Tecnis ZM900 shows stable surgical outcomes with a high satisfaction rate and enables a high rate of spectacle independency. Postoperative glare and halo, youth, and residual refractive error could be risk factors for dissatisfaction with monocular implantation of multifocal IOL Tecnis ZM900. Proper patient selection can lead to satisfying outcomes.
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